Assessment of the relationship of basal serum anti-mullerian hormone levels with oocyte quality and pregnancy outcomes in patients undergoing ICSI

Abstract

Background: Anti-Mullerian hormone (AMH) is constantly secreted during menstrual cycles and may offer several advantages over traditional biomarkers of ovarian reserve. Objective: To assess the relationship of anti-Mullerian hormone (AMH) values, which are used to evaluate ovary reserves, with oocyte and embryo quality and with ART outcomes in patients undergoing intra-cytoplasmic sperm injection (ICSI). Materials and Methods: This cross sectional study was performed using 50 women undergoing ICSI in IVF center of Zeynep Kamil Women's and Children's Hospital, İstanbul, Turkey. All patients received the long protocol. Follicle-stimulating hormone, luteinizing hormone, estradiol, and AMH levels were measured and antral follicle counts were obtained on the 3rd day of menstruation. A cut-off value based on the number of oocytes was determined for AMH, and women were evaluated after being divided into two groups as bad responders and good responders, according to their AMH levels. Results: Twelve (27.3%) women were in bad responders group and 32 (72.7%) women were in good responders group. AMH measurements were statistically significantly different between the two groups (p<0.01). Based on this significance, the researchers used ROC analysis to estimate a cut-off point for AMH. The researchers detected the good responders with an AMH level 1.90 or above, with 87.50% sensitivity, 66.67% specificity, 87.50% positive prediction, and 66.67% negative prediction (AUC=0.777, p<0.01). Conclusion: Basal AMH levels can be used as an indicator to determine the ovarian response in women undergoing ICSI. AMH can be used to predict the number of mature oocytes that can be collected during treatment and the number of oocytes that can be fertilized. However, AMH is not a valuable tool to evaluate oocyte quality, the development of high-quality embryos, or pregnancy conception.